Substance Abuse Prevention and Control
Fiscal & Operational Efficiency
As of the implementation of behavioral health payment reform in July 2023, DMC-ODS services are reimbursed via fee-for-service (FFS) instead of being reimbursed via cost reconciliation (reconciling to the lesser of costs or charges), and there are practitioner-level rates for outpatient services. This effectively means that once a claim has been approved and paid, there will be no other reconciliations or payments involved for that claim. This change brings significant opportunity if agencies optimize their fiscal and operational efficiencies by ensuring that enough appropriate treatment services are delivered to generate sufficient revenue to cover operational costs. This component of Capacity Building is focused on making investments to support this optimization.Capacity-Building
3A. Accounting Infrastructure: Systems and CapacityProvides funds to invest in new accounting systems and/or strengthening existing accounting systems and organizational capacity with summary of investments due with Invoice 2 on 12/31/23.
- Invoice 1: Start Up Funds Attestation07/15/23
- Invoice 2-Deliverable Based Efforts03/31/24
- Invoice 1: Start Up Funds Attestation
3B. Expenditures and Revenue: Assessing and Enhancing Financial Health
- 3B-1 Supports providers to develop expenditure and revenue management skills by attesting to participate in the CIBHS- Assessing & Enhancing Financial Health (AEFH) training series.
- 3B-2 Indicates completion of AEFH training and successful monitored, maintained and documented use of the Revenue/Expenditure Tool for a minimum of 6 months.
